The patient have distinct psychological features during the periods respectively before examination, in process of examination and after examination.The medical staff could relieve the negative reaction of patients by particularly taking some communicating methods and skills.

BACKGROUND:Bone ultrastructural destruction is an important cause for bone strength decrease,bone friability and bone fracture incidence increase in osteoporosis.OBJECTIVE:To observe the ultrastructural changes of distal femur cancellous bone in glucocorticoid (GC)-treated rats by scanning electron microscopy (SEM).METHODS:A total of 32 female Sprague-Dawley rats,aged 3.5 months old,were respectively treated with methylprednisolone 3.5 mg/kg per day by subcutaneous injection to induce osteoporosis and normal saline.At 4 and 9 weeks,the distal femurs were coronary sectioned and rinsed with distilled water,dehydrated in graded ethanol,coated with gold,and observed by SEM.RESULIS AND CONCLUSION:Compared to the control,the number of bone trabeculae in the GC group was significantly decreased,and the bone trabeculae became thin,fragile,discontinuous;network structures of bone trabeculae were destroyed,and bone resorption surface increased,with disorderly arranged collagenous fibers and increased micro-damage.Rats treated with GC for 4 weeks maintained better bone ultrestructure compared with rats treated with GC for 9 weeks.Results show that GC can induce bone mass lost,destroy network structures of bone trabeculae,accelerate bone resorption in rat cancellous bone,and accordingly lead to increased bone brittleness and decreased bone functional of biodynamics.

Objective: To observe the effect of early pelvic floor muscle rehabilitation on postpartum pelvic floor rehabilitation and sexual function in different delivery methods. Methods: Ninety-three parturient women who admitted to the Department of Obstetrics and Gynecology in Taizhou Hospital from January 2018 to December 2018 were divided into cesarean section group (53 cases) and vaginal delivery group (40 cases) according to the mode of delivery.Early pelvic floor muscle rehabilitation was performed in both two groups.Maternal pelvic floor rehabilitation was assessed by pelvic floor muscle pressure and muscle fiber contraction, and maternal sexual function was assessed by sexual function status score. Results: Before treatment, the sustained systolic blood pressure of type Ⅰ muscle fibers[(28.14±3.03)cmH₂O vs.(27.66±3.14)cmH₂O], the duration of type Ⅰ muscle fibers[(9.54±1.04)s vs.(9.66±1.00)s], the rapid systolic blood pressure of type Ⅱ muscle fibers[(48.14±3.03)cmH₂O vs.(47.66±3.14)cmH₂O], and the contraction of type Ⅱ muscle fibers[(2.54±1.04) vs.(2.66±1.00)] had no statistically significant differences between the two groups (t=0.401, 0.312, 2.401, 0.324, all P>0.05). After treatment, the sustained systolic blood pressure of type Ⅰ muscle fibers, duration of type Ⅰ muscle fibers, rapid systolic blood pressure of type Ⅱ muscle fibers, and the contraction of type Ⅱ muscle fibers had statistically significant differences between the two groups (t=10.642, 10.214, 10.672, 10.254, all P<0.05). There were no statistically significant differences in resting pressure and pelvic systolic pressure between the two groups before intervention (all P>0.05). After intervention, both two indicators were elevated, and the differences were statistically significant compared with before treatment (t=12.093, 14.152, all P<0.05). The resting pressure and pelvic systolic pressure in the cesarean section group were higher than those in the vaginal delivery group, the differences were statistically significant (t=11.642, 10.234, all P<0.05). Compared with before intervention, the indicators and total scores of sexual function in the cesarean section group were better than those in the vaginal delivery group, the differences were statistically significant (t=15.401, 17.312, 19.645, 19.401, 17.312, all P<0.05). After intervention, the maternal sexual function indicators and total score in the two groups were increased, and the differences between the two groups were not statistically significant (t=0.642, 1.214, 0.468, 0.668, 0.068, all P> 0.05). Conclusion Early pelvic floor rehabilitation is beneficial to the recovery of pelvic floor and sexual function.

Objective To compare the therapeutic outcomes between laparoscopic radical Rephrectomy and open radical nephrectomy for renal cancer. Methods A prospective randomized controlled trial was performed in Fujian Provincial Tumor Hospital from January 2006 to July 2009.Sixty-two cases were randomly divided into 2 groups:laparoscopic radical nephrectomy and open radical nephrectomy.Primary outcome(post-operative hospital stay)and second outcome(estimated blood loss,operative time,incision length,post-operative complications,recurrence,metastasis and survival)were compared between 2 groups. Results Post-operative hospital stay was(5.4±1.3)d in laparoscopic group and(8.1±2.2)d in open group(P<0.05).Median estimated blood loss was 100 ml in laparoseopic group and 200 ml in open group(P<0.05).There were no significant difference between teh 2 groups in operative time,post-operative complications,recurrence,metastasis and survival rates(P>0.05). Conclusion Laparoscopic nephrectomy could reduce hospital stay,which provides a minimally invasive approach for renal cancer.

To sum up the reform of internal performance appraisal system and income allocation system of Shanghai municipal hospitals.The internal performance appraisal index system,evaluation methods and corresponding income allocation system,featuring two breaks,one change and eight elements.The reforms highlight public welfare nature of public hospitals,which is expected to create profound impacts on hospital operation and medical staff behavior.

Objective To investigate the value of the shear wave elastography ( SWE) in the diagnosis of biliary atresia ( BA ) in infants by ultrasonography . Methods SWE was used to measure the liver stiffness measurement( LSM ) of 138 infants . Following surgical or pathological diagnosis ,the infants were subclassified into BA and non-biliary atresia ( non-BA ) groups . ROC analysis was used to determine the sensitivity and specificity of LSM ,the ultrasonic findings in the differential diagnosis of suspected BA ,and the cut-off value to diagnose BA . Results Of the 138 infants with cholestatic hepatitis ,51 were diagnosed as BA group and 87 cases were assigned to the non-BA group . The ROC analysis showed the cut-off value of LSM for diagnosis of biliary atresia in children with jaundice was 12 .35 kPa ,the AUC was 0 .936 ,and the sensitivity and specificity were 84 .3% and 89 .7% ,respectively .In the parallel test ,the triangular cord ( TC) sign combined with abnormal gallbladder ( AbGB) had the best diagnostic performance in all patients . However ,in patients older than 30 days ,the LSM combined with TC had the best AUC ( 0 .987 ) and diagnostic performance( 98 .6% ) like with TC combined with AbGB . Conclusions Both SWE and gray scale ultrasound have higher diagnostic performance for BA . LSM can be used as a valuable index for diagnosing BA by ultrasound .

Objective:To explore the influence of interpregnancy interval (IPI) on pregnancy complications in multiparas.Methods:This was a retrospective cohort study involving 7 669 singleton parturients who delivered at ≥28 gestational weeks in the Affiliated Hospital of Southwest Medical University between December 2015 and December 2020 and had given birth in the third trimester before. Clinical data were collected, including the baseline characteristics, pregnancy complications, gestational weeks at delivery, and neonatal birth weight. According to the IPI, these women were divided into five groups: <12 months ( n=350), 12-<24 months ( n=945), 24-<60 months ( n=2 544), 60-<120 months ( n=2 478), and ≥120 months ( n=1 352). Based on the recommendation of the World Health Organization, pregnant women with an IPI of 24-<60 months were the control group. A multivariate logistic model was used to adjust for confounders and calculate the risks of pregnancy complications, including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP). The influences of maternal age and previous delivery mode on the associations between IPI and maternal complications were analyzed. Analysis of variance (ANOVA), Chi-square test, and Cochran-Mantel-Haenszel Chi-square test were used for statistical analysis. Results:Compared with the control group, the incidence of GDM and HDP increased in the 60-<120 months group ( OR=1.23, 95% CI: 1.01-1.48 and OR=1.47, 95% CI: 1.13-1.92) and ≥120 months group ( OR=1.37, 95% CI:1.07-1.78 and OR=1.92, 95% CI: 1.39-2.64); the risks of uterine rupture/postpartum hemorrhage and placental abruption increased in the <12 months group ( OR=1.54, 95% CI: 1.01-2.34) and 12-<24 months group ( OR=2.38 95% CI: 1.13-5.02), respectively. In the 60-<120 months group, the risk of GDM increased only in non-elderly women (adjusted OR=1.71, 95% CI: 1.36-2.14), so did the risks of GDM and HDP in the ≥120 months group (adjusted OR=3.11, 95% CI: 2.10-4.62 and adjusted OR=1.81, 95% CI: 1.12-2.91). Among women who had undergone a previous cesarean section, the risk of GDM increased in the ≥120 months group (adjusted OR=1.35, 95% CI: 1.00-1.81). In the 60-<120 months group and ≥120 months group, the risk of HDP increased in postpartum women (adjusted OR=1.79, 95% CI: 1.08-2.95 and adjusted OR=3.32, 95% CI: 1.91-5.77). Conclusion:IPI≥60 months is a risk factor for GDM and HDP, and the associations between IPI and maternal complications are influenced by maternal age.

Klotho gene was originally discovered as an anti-aging gene, Klotho protein encoded by Klotho gene is expressed in multiple human tissues, and its most prominent function is the regulation of phosphate homeostasis. Klotho protein possesses various activities, including inhibition of multiple signaling pathways, reducing oxidative stress and suppressing inflammation, and these activities are associated with cancer. Klotho protein is discovered as a universal tumor suppressor, and its expression is associated with tumorigenesis and prognosis of patients. Lung cancer is the most common malignancy tumor, and it is the leading cause of cancer deaths worldwide because of its high incidence and mortality. This article summarizes the research progress of the role of Klotho on pathogenesis, therapeutic effect and prognosis in lung cancer, in order to provide new biomarker and target for diagnosis, treatment and prognosis of lung cancer.
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Humans ; Lung Neoplasms ; Carcinogenesis ; Inflammation